Lack of folate, carotenoids raising heart disease levels in CEE
contributing factor to the high rate of heart disease in Central
and Eastern Europe, say researchers.
A dramatic increase in heart disease in this region is responsible for the strong decline in life expectancy in many newly independent states in Central and Eastern Europe, writes the team from the US-based Oregon Health and Science University in this month's issue of the Journal of American Dietetic Association (vol 104, issue 12, pp1793-9).
But traditional risk factors like smoking, obesity and high dietary saturated fat do not explain this escalation.
Using data from the UN Food and Agriculture Organization, the researchers assessed food consumption in 19 different countries grouped into four regions based on their cultural patterns - Central and Eastern Europe, Western Europe and the US, Mediterranean countries and Asia.
Death from heart disease in the CEE countries - Czech Republic, Estonia, Hungary, Lithuania and the Russian Federation - was six to seven times higher than in Japan, three to four times higher than in the Mediterranean countries, like France, Spain and Greece, and one and a half times higher than Western Europe.
Backward elimination multiple regression analysis was used to identify independent predictors of mortality. Intake of folate, fibre and omega-6 and -3 fatty acids played a major role in the variation in coronary mortality, shows the study, but folate played the greatest role.
A lack of the B vitamin has been linked to raised levels of the heart disease risk marker homocysteine.
Folate was however intercorrelated with the carotenoids lutein/zeaxanthin and beta-carotene."All three nutrients tend to be present in the same foods derived from plants; they could even play a synergistic role in the protection against heart disease," note the researchers.
The findings confirm the significant opportunity for the supplements and functional food industry in the emerging Central and East European markets.
Indeed the researchers point to the 'unique situation' of Poland in this region - it has low coronary mortality and high intake of folate and other protective nutrients. This suggests that an increase in such foods in other countries could prove beneficial.
While heart disease cannot be explained solely by diet, it may have had a significant impact on lives already, according to the scientists.
"The terrible toll from sudden death that is particularly striking in men aged 30 to 50 years [in Central and Eastern Europe] is likely the result of a combination of factors."
"Still, the diets in these countries that are high in pathogenic dietary factors and low in protective dietary factors, especially folate and carotenoids, may help explain the very high death rate from coronary disease in both men and women in Central and Eastern Europe."
